The Primary Prevention of Hepatitis C among Injecting Drug Users

Advisory Council on the Misuse of Drugs
Hepatitis C is a significant public health issue. It has been estimated that in 2003 in England and
Wales there were around 190,000 individuals infected with the hepatitis C virus (HCV). It is likely that over 80 per cent of current HCV infections are due to injecting drugs and that around 50 per cent of injecting drug users (IDU) in the UK are infected with HCV. Moreover, of those IDU who are infected, approximately half may be unaware that they are HCV positive. It is likely that HCV prevalence fell during the early and mid 1990s, but the trends have now reversed and among recent IDU HCV prevalence almost doubled between 1998 and 2007.

These statistics are set against a backdrop of an expansion of diagnostic and treatment services as part of the HCV Strategy and HCV Action Plan in England and the HCV Action Plan in Scotland.
In reviewing the evidence, we conclude that a single intervention may not, alone, be sufficient to
prevent the spread of the hepatitis C virus. The evidence suggests that the most effective way of
reducing HCV incidence among active IDUs is through a combination of Opiate Substitution Therapy (OST) and the provision of Needle and Syringe Programmes (NSP).

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